Behavioral sciences

By
Faisal Mehboob

Introduction

Introduction
Study of human behavioral by using the principles of
psychology, sociology and anthropology in conditions of
health and disease is term as Behavioral science.
Study of effects of evolutionary history of human beings,
their cultural history, racial classification, geographic
distribution of human races, and effects on health issue and
signs and symptoms of diseases is term as anthropology.

Non-Pharmacological
interventions in Clinical
practice

Communication skills
Attending and listening
Active listening
Verbal techniques (FCPS)

Funneling
Paraphrasing
Selective reflection
Checking for understanding
Empathy building

Counselling
Steps

Donts of Counselling

1. Establishing a relationship of mutual

Dont ask Why questions.

Dont use should or Ought.
Dont blame the patient.
Dont automatically compare the
pateints experience with your own.
Dont invalidate the patients feelings.

trust and caring

2. Giving patient or their families a

chance to seek clarifications
3. Providing an opportunity to patients
to freely express
4. Achieving a deeper and clearer
understanding of health related
issue.
5. Making a descion
6. Seeking support of the counsellor
7. Learning the necessary skills to deal
with the issue.

Misconceptions about Counselling

It makes people less emotional.

It involves giving direct advice to
patient and attempts to solve problems
for them.
It involves challenging a patients
feelings and perceptions in order to
impose ones own values and
perceptions.
Counselling is an activity which implies
need of the counsellar to make people
fee and function better.

Informational care
Provision of information to patients regarding the disease, drugs and doctor that
concern him/him is term as informational care.
Seven essentials in informational cares
1. The informational care session must be takes place in the language that the
patient can understand.
2. It must start with patients knowledge, understanding and expectations.
3. Doctor must then remove any myths and misconceptions that the patient
mention in his description.
4. Task of giving information should be professionalized.
5. Both aspects of disease and treatment, negative and positive should be
communicated to the patient, but avoid the information OVERLOAD.
6. Use of simple figures and diagrams to enhance the patient understanding.
7. IC session end with the patient briefly ahis new understanding.

Crisis interventions /
Disaster Management

Roberts model of crisis

interventions (P EID AAA)

Types of crisis

1. Plan and conduct a crisis assessment

2. Establish rapport and rapidly
establish relationship
3. Identify major problems
4. Deal with feelings and emotions
5. Generate and explore alternatives
6. Develop and formulate and action
plan
7. Establish follow-up plan and
agreement

Developmental crisis
Common and occur in stressful
periods e.g. childbirth, death of
loved ones
Situational crisis
Which occur in man made
disaster e.g. floods, earthquake,
rape, war, murder.

Communication strategies in
crisis interventions (SN-PRE)
Using silence
Using non-verbal
communication
Paraphrasing
Reflecting feelings
Allowing the expression of
emotions

Disaster management
It follows three phases

Emergency phase
Rehabilitation phase
Recovery phase

(ERR)

Conflict resolution

Conflict resolution
a state where two equally strong forces oppose each other.
Common causes of conflict in health
settings (PEN V PAK)

When needs and wants not being

met.
Values are being tested.
Perceptions are being questioned.
Assumptions are being made.
Knowledge is minimal.
Expectations are too high.
Personality, race, gender or social
class differences exist.

Methods of conflict resolution

(PC HAVE G)
Meet conflicts head on.
Set goals, that lead to win-win
situation for both parties in conflict.
Plan for resolving the conflict
through free communication.
Be honest.
Agree to disagree i.e healthy
disagreements lead to better
decisions.
Get individual ego, out of negotiation.
Discuss differences in values openly.

Bio-psycho-social model

Individualized disclosure model

(SP-IK-E-SP)

A general model or approach that posits that

biological, psychological an social factors, all
plays the imp role in functioning of disease or
illness is called Bio-psychosocial model.

Steps
Seating and setting (exclusivity,
involvement of significant others,
seating arrangements, be attentive
and calm listening mode,
availability)
Patient's perception
Invitation
Knowledge
Empathy
Summarize
Plan of action

In this model, the amount of

information disclosed and the
rate of its disclosure are tailored
to the desires of the individual
patient by doctor-patient
negotiation.

Presents by George Engel in 1970

Non-disclosure model

Paternalistic disclosure model

This model is based on the view that

under no circumstance should patients
be informed that they have acquired a
lethal disease, and that deception
should be used if necessary.

This model implies that information

about the patient's disease is the right of
the doctor and he delivers the
information in a sugar coating to
minimize the pain and distress of the
patient.

The disadvantages of this models are

1. The denial of opportunity to adjust
2. The trust in doctor is undermined
3. Opportunities for helpful interventions
are lost
4. Patient compliance is less likely.
5. There are chances that the patient
loses his sense of control.

Full disclosure model

this model giving full information to
every patient as soon as it known. It
is argued that this model promotes
doctor-patient trust and
communication and facilitate
mutual support within the family
unit.

Major Challenges in Breaking Bad News

We need to know that it takes time to break bad news. To impart the
information to a person that he may have cancer or AIDS is to inflict a
major psychological trauma.
Life-threatening illness can undermine the confidence and trust of us
all , and the process of revising ones internal model of the world is
made easier if the issues are clear and if there is someone nearby who
will keep us safe during the period of vulnerability.
People will remember, for the rest of their lives, the details of the
occasions when important news was broken.
Before telling people what we think they need to know, or think they
know, about the situation and what their priorities are.

For more notes.

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